European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Fentanyl and bupivacaine mixture for extradural blockade in orthopaedic surgery: effects on haemodynamic responses and pain related to the use of thigh tourniquet.
Analgesic and haemodynamic changes due to tourniquet application were investigated in a prospective double-blind study on orthopaedic patients submitted to extradural lumbar blockade with a bupivacaine and fentanyl mixture. The study was carried out in 161 healthy patients undergoing limb surgery with a thigh tourniquet. Patients were randomly assigned to two groups: each group received treatment with bupivacaine 0.5% containing 1:200,000 adrenaline. ⋯ A dramatic reduction in intra-operative supplemental analgesic needs was observed in the B:F 200 group. This group of patients also complained less of tourniquet pain than their counterparts, for the first 30 min of application. Our study underlines the value of fentanyl addition to bupivacaine in extradural blockade in orthopaedic surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of a heat and moisture exchanger on carbon dioxide equilibrium during mechanical ventilation with the Bain circuit.
The introduction of a heat and moisture exchanger (HME) into the anaesthetic circuit may cause a rise in carbon dioxide (CO2) tension through an increase in dead space. We studied the effects of the Ultipor Pall BB50 filter included 'in series' in the Bain circuit on CO2 equilibrium. ⋯ Results showed that: females were always more hyperventilated than males when fresh gas flow was set at 70 ml kg-1 ideal body weight; the inclusion of the filter increased the PaCO2 in the group as a whole (the difference was statistically, but not clinically, significant); PaCO2 increased after the application of the filter only in females; the effects of the filter were completely independent of the patient's age. It is concluded that the use of the Ultipor Pall BB50 filter is a safe procedure during mechanical ventilation with the Bain breathing system and there is no need to modify ventilation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Post-operative morbidity associated with the use of atracurium and vecuronium in day-case laparoscopy.
Patients were randomly allocated to receive either vecuronium or atracurium as the sole muscle relaxant for day-case gynaecological laparoscopy to determine if either agent was superior with respect to post-operative morbidity during the 48 h after operation. Intubating conditions and cardiovascular stability were similar in both groups. ⋯ There was no statistical difference in specific morbidity during the 48 h after laparoscopy, but a greater number of patients in the vecuronium group was able to resume normal activity 24 h after laparoscopy. Both agents are very suitable for day-case laparoscopies and other short surgical procedures.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
The effect of atracurium, vecuronium and pancuronium on heart rate and arterial pressure in normal individuals.
Heart rate and rhythm (from ECG) and systolic, diastolic and mean arterial pressures (using an oscillotonometer) were measured for 30 min following administration of atracurium 0.5 mg kg-1 (n = 20), vecuronium 0.1 mg kg-1 (n = 20) or pancuronium 0.1 mg kg-1 (n = 20) during steady-state anaesthesia, with nitrous oxide, oxygen and either 0.75% halothane or fentanyl 4-5 micrograms kg-1, in the absence of any surgical stimulation. Whereas atracurium and vecuronium were associated with only small and clinically unimportant changes in heart rate, pancuronium produced a marked and significant increase associated with a junctional rhythm in four patients. ⋯ No serious bradycardias were observed with either atracurium or vecuronium. Five patients showed cutaneous signs of histamine liberation after administration of atracurium.
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Randomized Controlled Trial Comparative Study Clinical Trial
The influence of cyclizine and perphenazine on the emetic effect of meptazinol.
The effectiveness of 50 mg cyclizine and 2.5 mg perphenazine against the emetic sequelae of 100 mg meptazinol were studied in a randomized double-blind placebo-controlled trial. Three groups of 40 women received the opioid, together with an anti-emetic by i.m. injection, as premedication prior to minor gynaecological surgery. Beneficial or noxious effects were noted at standard time intervals and anaesthesia standardized as incremental methohexitone with nitrous oxide/oxygen. ⋯ Perphenazine, 2.5 mg, showed no useful anti-emetic effect. Both anti-emetics increased the soporific effect of premedication at the 90-min interval. Subjects receiving perphenazine experienced significantly more dizziness than those of other groups.